Guest Blog: Health Careless

Comment: taken from http://bluegrassroots.blogspot.com


Sunday, October 24
Guest Blog: Health Careless
This from a law school friend of mine:Until this year, I was a registered Republican. Finally, in August, I changed my registration. I am now a Democrat. Looking back on the past four years, convincing me to change my voter registration is the best thing George Bush has done for me and my family since he was elected. I became pregnant with my 7 month old daughter in June of 2003. Both my husband and I were in school at the time; I was entering my second year of law school and he was entering his last year of college. I, like 45 million other Americans, was uninsured. I was uninsured because, despite the fact that I came into law school with a scholarship that was to pay about 2/3 of my tuition annually when I received it, law school tuition has gone up from around $6800 in my first year to $10252 in my final year, in large part due to education cuts from the state and national level. I was uninsured because my husband’s Pell Grants had been cut in each of the four years he was enrolled in school, even as our cost of living was growing. I was uninsured because we could not afford to pay the premiums for student health insurance, and because insurance providers are only concerned with their bottom line, as private companies, no one would insure me with a “pre-existing condition.” (Note: this is not a criticism of private corporations generally but a mere aside; their concern with their bottom line is understandable since they are in business to make money. But isn’t it alarming to people that we put our very health care into the hands of private corporations? Isn’t it disturbing that companies whose goal is to make money are making decisions about what medical procedures you and your family will or won’t be allowed to have? Private for-profit health insurance companies spend between 20 and 30 % of premiums on profits and administration; the federal Medicare system spends only 3% on administration.)As soon as I found out I was pregnant, I stupidly tried to get student health insurance anyway. I knew I could not afford the cost of prenatal care, let alone the expense of having a baby. But I still wanted to be responsible—I wanted to be able to do what I thought was right, and contribute something to my health care, even if it was just in the form of insurance premiums. I was of course denied. I needed help—my first of many prenatal visits cost nearly $700. Although I was resistant to the idea, I knew my only option was to apply for Medicaid. As a pregnant student, I easily qualified and all my prenatal and delivery costs were covered. I appreciated the irony every month when my medical card came in the mail, emblazoned on the outside with the words “Education Pays in Kentucky.” I couldn’t help but think that education did not, in fact, pay in my life at that time; had I not been a student, in a graduate program whose tuition has increased by over $2000 per year in the past two years, I would have been able to afford private health insurance. I would have been able to hand the receptionist an insurance card instead of a Medicaid card at my doctor’s appointments, and not have felt as though I were being judged every time I had an appointment, by someone who knew nothing about me or my situation. Many people have such a negative impression of Medicaid recipients, believing anyone who benefits from public programs like WIC, Medicaid, or food stamps is lazy and unemployed. For 1 year, I was a Medicaid recipient and was none of those things; I worked when I could, and stayed in school throughout my pregnancy. Medicaid recipients are no longer on the fringes: they are our friends, neighbors, and family members. They are graduate students and the working poor. I was one of 45 million Americans—17% of the total population—who were unable to get health insurance because of the broken health care system that exists in our country today. This number is up from just 15 million uninsured Americans in 1999. You may be thinking, “of course the health care system is broken. Tort reforms are needed in order to decrease the costs of health care for all Americans.” This is simply not true. The traditionally proposed tort reforms which cap a plaintiff’s punitive damages have been proven ineffective in many states where they have been enacted. Because most physicians have an upper limit on their malpractice liability insurance coverage for punitive damages, such reforms would be largely ineffective in many states for physicians. Further, try telling a mother who has just lost her baby due to medical negligence that her recovery is limited to $250,000 or some other arbitrarily created amount. It is the availability of punitive damages claims that protect the indigent from unaccountable practices and provide the only recourse for many individuals from negligent medical action. If tort reforms are to be enacted, they must be of the type supported by John Kerry—cutting off frivolous lawsuits before they get to the courtroom. Limiting a truly damaged plaintiff’s right to recover does not solve the problem of high malpractice premiums—it merely takes away one of a patient’s few remedies against malpractice. It is possible to emerge from this broken health care system with a plan that protects all Americans—old or young, poor or wealthy, whatever their race or personal situation—a system of universal health care (UHC). Now of course, many oppose such a plan because they “know someone who lives in Canada, where health care is terrible.” I have experienced a UHC system—namely, the health care provided to military members and their spouses. I have not experienced any major problems in scheduling appointments or in the quality of care provided. The 2002 Kaiser Report on Medicaid and the Uninsured found that the federal government spent about $146 billion on Medicaid that year, and states kicked in an additional $100 billion. The Government Accounting Office estimates that switching to a single-payer UHC system would save about $67 million almost immediately in administrative insurance overhead costs; a Harvard University study estimated that UHC could save $286 billion per year on a reduction in paperwork alone in a UHC system—enough to provide health care and full prescription drug coverage to all Americans. The cost of providing health insurance to all Americans—the previously insured and the newly insured—is estimated by the GAO to be $64 billion annually. Furthermore, the U.S. spends 40% more per capita on health care than any of the 28 industrialized nations which have a UHC system in place. Thus, the federal government in conjunction with the states could provide UHC to ALL AMERICANS for less than the cost of providing Medicare and Medicaid to current recipients. If the inability of the poor to obtain health insurance is not incentive enough to provide UHC for all Americans, consider this: my baby daughter was born with a congenital heart defect. A heart defect that was classified by insurance companies as a pre-existing condition, and whose care could not be covered by a private insurance company for a year or more after my baby’s birth. That a baby can be born with a pre-existing condition is utterly ridiculous. Were we not covered under the military’s UHC system, Tricare, we would have had to pay for my daughter’s health care for this defect for at least a year under most private insurance schemes. This includes expensive procedures like chest x-rays, EKGs, and Echocardiograms. It includes visits to a pediatric cardiologist and more detailed exams at her routine checkups. Thankfully, the defect is easily treatable with surgery which will take place several years from now, but what about other children who are born with more serious pre-existing conditions? What could be more devastating to a working poor family with a sick child, trying to get by and get off Medicaid, than to be told that when you do finally succeed your child’s medical bills won’t be paid for? What is the incentive to try under our current scheme? The cost to the average American would not increase under a single-payer UHC plan, either. Anyone who is responsible for paying his own health insurance premiums and co-pays knows that these costs have spiraled out of control in the past few years—particularly in our home state. Kentucky state employees pay an average premium of $541 per month for health care—that’s about $6500 per year. These premiums are the highest in the nation and do not include co-payments and deductibles. For many state employees—including hard-working teachers who went to college for four or more years, whose wages do not reflect the effort they put into their jobs--$6500 per year is devastating. This is surely not the best our government can do by its families. This is surely not what the Commonwealth means when it claims on Medicaid cards that, in Kentucky, “Education Pays.”